RCT evaluating provider outcomes by suicide prevention training modality: in-person vs. e-learningMagruder, Kathryn Marley; York, Janet Ann; Knapp, Rebecca G; Yeager, Derik Edward; Marshall, Elizabeth; DeSantis, Mark
2015 The Journal of Mental Health Training, Education and Practice
doi: 10.1108/JMHTEP-09-2014-0028
Purpose– The purpose of this paper is to evaluate provider outcomes in response to two modes of suicide prevention training (e-learning and in-person) and a control group. The Collaborative Assessment and Management of Suicidality (CAMS) was adapted for e-learning delivery to US Veterans Administration mental health providers. Outcomes include: self-evaluated beliefs, ability, and self-efficacy in managing suicidal patients. Design/methodology/approach– This study used a multicenter, randomized, cluster design to test the effectiveness of e-learning vs in-person conditions CAMS for changes in provider outcomes. Findings– Survey scores showed significant improvements for both the e-learning vs control and the in-person vs control between pre-intervention and post-intervention; however, the e-learning and in-person conditions were not significantly different from each other. Research limitations/implications– Limitations of the study include that there were drop-outs over the study period and the survey questions may not have captured all of the aspects of the CAMS training. Practical implications– Results suggest that e-learning training modules can provide comparable outcomes to in-person training for suicide prevention. Social implications– More providers may have accessible training materials for managing suicidal patients. Originality/value– Currently practicing providers now can choose between two equivalent training modalities for improving the management of suicidality in their patients.
Mental health nurses’ perceptions of attachment style as a construct in a medium secure hospital: a thematic analysisBoniwell, Nikki; Etheridge, Leanne; Bagshaw, Ruth; Sullivan, Joanne; Watt, Andrew
2015 The Journal of Mental Health Training, Education and Practice
doi: 10.1108/JMHTEP-01-2015-0002
Purpose– Attachment Theory can be regarded as central to the concept of relational security. There is a paucity of research examining the coherence of this construct for ward-based staff. The paper aims to discuss these issues. Design/methodology/approach– Five female nurses from the acute admission and assessment ward of a UK medium secure unit acted as participants. Semi-structured interviews were conducted, and inductive thematic analysis was applied. Findings– Six themes; “staff-service user relationships”, “staff diversities”, “service user backgrounds”, “variability in service users’ presentations”, “service users with personality disorder are problematic” and “nurses do not use attachment” emerged from the data. The nurses used heuristic models of attachment-related behaviour and they lacked knowledge of constructs associated with Attachment Theory. Research limitations/implications– Acute admissions may not be representative of all treatment contexts. Traditional models of attachment style may have only limited relevance in forensic services. Practical implications– Limited knowledge and confidence in the nurses regarding how Attachment Theory might apply to service users is interesting because it may limit the extent to which care, treatment and risk management might be informed by an understanding of service user representations of therapeutic relationships. Training and educational interventions for nurses that enhance understanding of personality development and attachment styles are warranted. Originality/value– The importance of nurses for achieving relational security is emphasised and the adequacy of their training is questioned.
Narratives of experts by experience: the impact of delivering training in partnership on the subject of personality disorderCooke, Samantha; Daiches, Anna; Hickey, Emma
2015 The Journal of Mental Health Training, Education and Practice
doi: 10.1108/JMHTEP-03-2015-0012
Purpose– As part of an attitudinal shift surrounding personality disorder stigma, a training package termed the Knowledge and Understanding Framework (KUF) is delivered in collaboration between experts by experience (EBE) and professionals. The purpose of this paper is to explore the narratives of EBE delivering KUF; in particular the impact of this role and its varying contexts. Design/methodology/approach– Eight women took part in the study and a narrative analysis explored their stories. Findings– The analysis suggested five temporal chapters: first, life before becoming involved: “Like being in a milk bottle screaming”; second, a turning point: “It wasn’t actually me that was disordered it was the life that I’d had”; third, taking up the trainer role: “It all just […] took off”; fourth, the emergence of a professional identity: “I am no longer a service user”; and fifth, impact on self, impact on others. Originality/value– The use of qualitative literature is sparse within co-production research. The study therefore adds value in exploring in-depth experiences of the phenomena.
Rethinking pathways to completed suicide by female prisonersOakes-Rogers, Sophie; Slade, Karen
2015 The Journal of Mental Health Training, Education and Practice
doi: 10.1108/JMHTEP-02-2015-0008
Purpose– The purpose of this paper is to explore the role of trauma experience in pathways to self-harm or attempted suicide in female prisoners who died through self-inflicted death in England and Wales. Design/methodology/approach– Quantitative study using the Prison and Probation Ombudsmen’s independent reports on deaths in custody. In total, 32 cases of female self-inflicted death in custody were coded on the presence of direct or interpersonal trauma, presence of superficial self-harm (SSH), near-lethal self-harm (NLSH), suicide attempts and recent significant life event. The number of previous suicide attempts (PSAs) and age at time of death was recorded. Findings– Direct trauma is linked with repeated suicide attempts but recued the likelihood of SSH prior to suicide. Neither interpersonal trauma nor age increased likelihood of pre-suicide behaviours. NLSH was not predicted by either traumatic experience. Amongst these completed suicide cases, 56 per cent were not reported as having experienced trauma, 46 per cent had no recorded PSAs and 12 per cent also had no previous self-harm reported. Research limitations/implications– The small sample limited statistical power and specificity of classifications. Provides support for direct trauma in developing capacity for repeated suicidal behaviour as indicated in theoretical models of suicide (Joiner, 2005; O’Connor, 2011). Practical implications– Different pathways to suicide likely to exist for female prisoners and importance of trauma intervention services. Originality/value– Using cases of completed suicide in female prisoners to investigate the pathway to suicide from trauma through previous self-harm and attempted suicide.
Enabling practitioners working with young people who self-harmFoster, Celeste; Birch, Lynsey; Allen, Shelly; Rayner, Gillian
2015 The Journal of Mental Health Training, Education and Practice
doi: 10.1108/JMHTEP-05-2014-0011
Purpose– The purpose of this paper is to outline a UK-based interdisciplinary workforce development project that had the aim of improving service delivery for children and young people who self-harm or are feeling suicidal. Design/methodology/approach– This innovative practice-higher-education partnership utilised an iterative consultation process to establish the local workforce need and then facilitated the systematic synthesis and presentation of evidence-based clinical guidelines in a practical format, for staff working directly with young people who self-harm in non-mental health settings. Findings– The development, content and structure of this contextualised resource is presented, along with emerging outcomes and learning from the team. It is anticipated that this may also be a useful strategy and resource for other teams in other areas and is intended to provide a template that can be adapted by other localities to meet the specific needs of their own workforce. Practical implications– The paper demonstrates how higher education-practice partnerships can make clinical guidelines and research evidence in a field often thought of as highly specialist, accessible to all staff. It also shows a process of liaison and enhanced understanding across universal/specialist mental health service thresholds. Originality/value– This paper demonstrates how collaborative partnerships can work to bridge the gap between evidence-based guidelines and their implementation in practice, through innovative multi-agency initiatives.